[External beam irradiation of head and neck cancer]. / Perkutane Strahlentherapie maligner Tumore im Kopf-Hals-Bereich.

Ionising rays are employed in percutaneous radiation of head and neck tumours. Radiation reduces cell division in the target tissue. The individual parameters of the radiation procedure are determined within the framework of the interdisciplinarily conceived treatment. Tumour control probability depends on tumour-specific factors and on the dosage as well as on the treatment period. The macroscopic and microscopic extend of the tumour area determines the target volume and dosage of the radiation. Conformal radiation is the standard procedure in primary radiation treatment. The anticipated side effects influence the therapy concept and the radiation parameters. Long-term aftercare of the tumour patient is imperative.

Direction dependent projection fields for the fast DRR generation for medical 2D/3D registration.

The fast generation of digitally reconstructed radiographs is a prerequisite for intensity-based registration approaches. For our approach, extensive pre-calculations are necessary that are saved in what we call a direction dependent projection field. The projection field approach reduces the complexity of the DRR calculation from O(n(3)) to O(n(2)). This paper develops the theoretical background and gives first examples of the application of projection fields for the 2D/3D registration of X-rays to CT data.

Identifying BAC clones for diagnosis of conventional renal cell carcinoma by FISH.

AIMS: The new classification of renal cell tumours relies on tumour-specific genetic alterations, which can be detected by different techniques. For diagnosis of conventional renal cell carcinoma by FISH we have isolated BAC clones from the chromosomal regions of interest. METHODS AND RESULTS: A BAC library was screened by microsatellites mapped to the smallest overlapping regions of loss of heterozygosity (LOH) at chromosomes 3p, 5q, 6q, 8p, 9p and 14q. Positive BACs were tested by carrying out FISH in normal cells for signal/noise ratio. Subsequently, 11 conventional and two papillary renal cell carcinomas were analysed by the new diagnostic BAC set and the results were compared with those obtained by microsatellite allelotyping. The diagnostic value of FISH was comparable to that of microsatellite analysis in nearly all tumours except those with extreme chromosomal polyploidization. CONCLUSIONS: We conclude that both FISH and microsatellite analyses are helpful to strengthen the diagnosis of conventional renal cell carcinoma. However, both techniques may have some disadvantage in a special setting.

[The significance of preventive CNS irradiation during antineoplastic therapy in childhood with regard to late odontogenic and mandibulofacial injuries]. / Die Bedeutung einer präventiven ZNS-Bestrahlung im Rahmen einer antineoplastischen Therapie im Kindesalter hinsichtlich dentogener und mandibulofazialer Spätschäden.

The aim of the present study was to determine the adverse effects of antineoplastic chemotherapy and radiotherapy on tooth development, i.e., on dentition in general and on craniofacial growth. The patients studied consisted of 26 children with solid tumors treated with chemotherapy alone and 34 patients with acute lymphoblastic leukemia (ALL) who were treated with intensive and follow-on radiation therapy (18 and 24 Gy) to the neurocranium as a constituent of central nervous system prophylactics in treatment protocols for ALL. The treatment protocol employed in these children is known as the BFM (Berlin, Frankfurt, Münster) protocol. At the time of diagnosis the children ranged in age from 3 to 52 months. All treated patients had microdontia, enamel dysplasia, thinning and tapering of apical roots portions, and marked shortening of the roots. These defects were more pronounced in children treated for ALL, but it was not possible to establish statistically relevant evidence on the influence of adjuvant radiotherapy in this group. This indicates that there is a catch up in craniofacial growth 9 years after therapy and that the most serious long-term adverse effects are on dentition.

Critical analysis of height reduction in oestrogen-treated tall girls.

Twenty-one girls with familial tall stature were reevaluated at 18 years of age. Fourteen of them had been treated with high-dose oestrogens (I), while seven girls had not been treated (II). The untreated group is comparable but not a strict control group. Recordings on initiation of the study were: Chronologic age: 12.0 +/- 1.4 (I) versus 13.5 +/- 1.5 years (II; means +/- SD), Bone age: (1) Greulich-Pyle: 11.8 +/- 1.4 (I) versus 13.1 +/- 1.1 years (II), (2) Tanner-Whitehouse II: 12.7 +/- 1.0 (I) versus 13.6 +/- 1.1 years (II). Mean height predictions according to (1) Bayley-Pinneau, (2) Roche-Wainer-Thissen and Tanner (3) with, and (4) without allowance for mid-parent height ranged from 179.4-184 (I) to 175.7-179.5 cm (II). In the treated group there was an average reduction of predicted height of between 2.3 and 6.5 cm, depending on which of the four methods was used. In the untreated group the average differences between calculated and observed mature height varied from 0.2-3.4 cm. The difference in the reduction of predicted height between the treated and untreated groups was significant (P less than 0.05) only with the Bayley-Pinneau method and not with the others. In the treated group highly significant correlations were found between height reduction and the initial chronologic age, bone age and duration of therapy.

Release of diacylglycerol moieties from various glycosyl diacylglycerols.

Periodic acid oxidation in methanol followed by incubation with 1, 1-dimethylhydrazine results in release of diacylglycerols from 1,2-diacyl-3-glycosyl-sn-glycerols. During hydrazinolysis of oxidized monogalactosyl diacylglycerol, an intermediate hydrazone derivative was observed which was isolated and identified. The diacylglycerols recovered are 1,2-diacyl isomers containing the same fatty acid mixtures as the intact glycolipids. The yields of diacylglycerols released from plant monogalactosyl-, digalactosyl-, and sulfoquinovosyl diacylglycerols were in the range of 30-50%. The method may be used for analysis of molecular species and for preparative purposes.

The effect of cyproterone acetate on adrenal cortical function in children with precocious puberty.

8 children with precocious puberty were treated with cyproterone acetate (CPA). During treatment there were no definite clinical signs of depressed adrenocortical function. The plasma cortisol concentrations were grossly depressed and the diurnal cortisol rhythm was abolished. Two months after discontinuation of CPA treatment the adrenocortical function had greatly improved. The lysin-vasopressin stimulation test revealed in one child a normal, in another child an exaggerated ACTH response during CPA therapy. Fasting plasma ACTH concentrations were elevated compared with normal controls, but they were very low compared with patients with Addison's disease. The results suggest that CPA has a twofold effect leading to adrenocortical insufficiency: i.e., inhibition of cortisol secretion by the adrenals themselves and inhibition of ACTH secretion at the hypothalamopitiuitary level.

Treatment of septicaemia in the newborn infant: choice of initial antimicrobial drugs and the role of exchange transfusion.

The therapeutic success of antibiotics used at the beginning of treatment and the effect of exchange transfusion in cases of septicaemia were tested in 22 newborn infants. The clinical course of these patients was compared with the outcome of 11 newborn infants who received antibiotic treatment without exchange transfusion. The following results were obtained: 1) All 6 patients initially receiving antibiotics, which were ineffective in vitro, died. In this group of patients the incidence of septic organ involvements (meningitis, ventriculitis, peritonitis) was significantly increased. 2) Following exchange transfusion, an impressive clinical improvement was consistently observed. 3) In patients who had initially received effective antibiotics and exchange transfusion, the lethality was significantly lower than in patients without exchange transfusion. 4) Our bacteriological findings show that continuous monitoring of cultures from blood, CSF and stool is necessary to choose the most effective antibiotic in the prevailing nosocomical circumstances.